Attentional bias toward alcohol stimuli as a predictor of treatment retention in cocaine dependence and alcohol user patients

Background: Attentional bias towards substance-related stimuli has shown to be involved in the development and maintenance of cocaine dependence. The relationship between alcohol use and cocaine dependence shown in literature justify the need of study these two substances jointly. Methods: This paper analyzes patterns of attentional bias in 71 patients with cocaine dependence and compares these patterns according to whether occasional or problematic concurrent alcohol use is taken into account. It also analyzes whether attentional bias towards alcohol and cocaine-related stimuli predicts treatment retention. Attentional bias was evaluated with a visual probe task between 15 and 20 days after admission to treatment. Treatment status was recorded at a three-month follow-up. Severity of dependence and cocaine and alcohol craving were also measured. Results: Results show that patients with cocaine dependence and problematic alcohol use show a pattern of approach towards alcohol stimuli (M = 8.32, SD = 27.01). In contrast, patients with cocaine dependence with occasional consumption of alcohol exhibit a pattern of avoidance of such stimuli (M = -7.23, SD = 19.20) (t = 2.79, p = 0.007). Logistic regression indicates that alcohol attentional bias is the only variable with predictive capacity (OR = 1.05, 95% CI = [1.01, 1.09]). It should also be noted that there is a pattern of avoidance of alcohol stimuli in patients who drop out of treatment. Conclusion: The results of this study suggest the need to delve into whether therapeutic strategies involving deeper emotional processing or avoidance strategies are more suitable for preventing relapse.